Provider Demographics
NPI:1922859479
Name:AZADI NAGHIBI DENTAL CORP
Entity Type:Organization
Organization Name:AZADI NAGHIBI DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZADI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGHIBI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-904-2148
Mailing Address - Street 1:11444 W WASHINGTON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-6060
Mailing Address - Country:US
Mailing Address - Phone:310-439-1910
Mailing Address - Fax:
Practice Address - Street 1:11444 W WASHINGTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6060
Practice Address - Country:US
Practice Address - Phone:310-439-1910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty